Republic of the Philippines )

________________) ) S.S.

AFFIDAVIT OF COHABITATION

We, ______________ and ________________, of legal age, single,

filipinos, and residents of ___________________, after having been duly sworn to in
accordance with law, depose and state:

1. That we are not married, not having been married before to anybody here in the
Philippines or elsewhere and we remain single and and unmarried up to the
present;

2. That we had been living and cohabiting as husband and wife and under one roof
without the benefit of the marriage up to the present;

3. That we are executing this affidavit to attest to the truth and veracity of the
foregoing statement and to inform proper authorities of the facts that we had
been living and cohabiting as husband and wife without the benefit of marriage
for more than eight (8) years since April 04, 2015 and for whatever legal
purposes it may serve.

IN WITNESS WHEREOF, I hereunto set my hand this ___________________.

_________________ __________________________
Affiant Affiant

SUBSCRIBED AND SWORN TO BEFORE ME this _______________________ at

_________________.